Archived: Fitzwilliam Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this service. This key question has been rated Requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always ensure information about people’s health, care, wellbeing and communication was correct or was being followed. For example, 1 person’s care plan stated they required the use of picture cards to support communication. Staff told us these were not used and they were not aware of this. Information about support needs was contradictory, in one place saying a person needed support and in another they did not. Another person required support with a phobia but the guidance again was contradictory in how to support this to minimise distress. This meant staff were being given confusing information that risked people’s needs and preferences not being met. Records failed to evidence how people were involved in their reviews. A person said, “[Staff] have not had conversations with me on my care.” A relative told us, “I’m not aware of a care plan. No discussion has been had regarding future care.”

The provider did not always evidence how people were supported to plan their care and treatment with them or how it was delivered in ways that were important to them. People’s health outcomes were recorded such as visiting from health professionals and health statistics such as weight, pulse, blood pressure. However, daily notes lacked context or evidence of person-centred approaches so evidence-based care lacked a holistic approach. Relatives told us they were not allowed to visit during mealtimes. Staff and managers told us mealtimes were protected. Managers were not aware of changes in regulation that meant providers could not impose a blanket ban on visiting in this way. Managers later told us this was only in place for certain people but the requirement for a protected mealtime had not been assessed or recorded for those people and the restriction was not included in their DoLS.

The provider worked well across teams and services to support people. Staff knew who to contact for support and advice if required. Referrals were made to specific health professionals such as dietitians or district nurses to support nursing tasks. The new manager worked with social care professionals and the local safeguarding team to implement changes to improve the quality of care. Professionals told us the staff team produced the records they requested and followed their guidance. They told us they had seen some improvement over the last 6 months due to the work of the compliance manager and were aware of further developments still to be put in place.

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People had their nutritional needs assessed and received appropriate nutrition, where they were intolerant to food groups or needed their food to be fortified this was accommodated. People told us they were supported to access health professionals such as doctors and dentists when needed. A person told us, “The doctor comes to [provide treatment]. The dentist came to check my teeth. I’ve had the optician come to check my glasses and the chiropodist is a lovely lady.” People had summary care plans called a hospital passports to give to emergency service personnel if they needed to go to hospital. This meant vital information about their health and preferences could be quickly and easily shared in an emergency.

The provider did not always effectively monitor people’s care and treatment to make sure it was effective and met their needs. For example, we identified concerns in monitoring how people were supported with medicines safety, care planning and environmental risks. Records did not clearly identify action that had been taken when there were concerns with people’s health checks. The provider had not independently identified these concerns before our assessment and only took action once we had identified risks.

People told us about the impact to their quality of life from these concerns not being acted upon by the provider. A person said, “’I don’t see [staff]. People [living with dementia] come down every day. The same few [people] come in, pick things up and worry me. There’s bad language and shouting at us. I press my buzzer and [staff] take them away. I have a key so I can lock myself in, but I shouldn’t have to and I prefer my door open else I can’t see or hear anyone nearby.”

People told us staff asked their consent before supporting them with personal care and respected their choices for daily decisions such as what to wear or how to spend their time. Staff had a good understanding of how to promote choice. However, the provider did not clearly evidence how they ensured people were supported with their rights around consent and despite people's views, we found the provider did not always respect people's rights when delivering care and treatment. For example, people who were unable to make decisions for themselves had mental capacity assessments completed. These assessments failed to evidence how people were involved or how they were supported to understand the decision being discussed and their rights. There was no evidence people had been given the opportunity to have advocacy support and no evidence of involvement by other representatives. Managers were unaware of any conditions imposed on deprivation of liberty safeguards approved to ensure these were being adhered to as they had failed to ensure the correct documentation was in place. Staff had a good understanding of how to promote choice. For people who were unable to make decisions for themselves, mental capacity assessments were completed. However, these failed to evidence how people were involved or how they were supported to understand the decision being discussed and their rights.